Do you need a referral for cancer pain management?

Referral rules vary between specialist pain and palliative medicine services. Your oncologist, surgeon or general doctor can send a request when needed, and the clinicians already treating you can assess pain and adjust initial support while the appointment is arranged.

Cancer pain management is tailored to the cause and pattern of pain rather than relying on one medicine. Assessment may cover pain from the tumour, treatment, surgery, nerve irritation, muscle strain or a separate health problem, as well as sleep, movement, mood and daily function.

Options can include changes to medicines, treatment for side effects, physical strategies, psychological support, radiotherapy or procedures where appropriate. Palliative medicine can provide pain and symptom support at any stage of cancer care and is not limited to care near the end of life.

Tell your cancer team about new, changing or poorly controlled pain rather than waiting for the next routine visit. Describe where it is, how it feels, what triggers it, whether it interrupts sleep or movement, and what happens after each prescribed dose.

Keep an up-to-date list of medicines, including non-prescription products, and note side effects such as constipation, nausea, sleepiness or confusion. Take pain medicines exactly as directed; do not increase, stop, crush or combine them without advice from a clinician or pharmacist who knows your regimen.

Seek emergency help for new severe back pain with leg weakness, numbness around the groin, or loss of bladder or bowel control. Sudden chest pain, severe breathing difficulty, collapse, a new seizure or sudden one-sided weakness also needs emergency assessment.

Contact the treating team promptly if pain escalates quickly, prescribed relief no longer works, you cannot keep medicines down, or a medicine causes marked drowsiness, confusion or slowed breathing. If slowed breathing or the person is difficult to wake, call emergency services.

Ask what may be causing each type of pain, when to use regular and as-needed medicines, which side effects to anticipate, and whom to call outside clinic hours. You can also ask whether movement support, nerve-pain treatment, radiotherapy, a procedure or palliative medicine input could complement the current plan.